Howell E M, Vert P
Mathematica Policy Research, Washington, DC 20024.
Pediatrics. 1993 Feb;91(2):464-9.
This study investigated the factors influencing use of neonatal intensive care and perinatal mortality in regions of the United States and France, two countries with similar health care systems but different approaches to health financing. The study employed birth certificates from Michigan and a birth registry from Lorraine in 1984. The study showed that geographic access and socioeconomic status were important in determining use of neonatal intensive care in both regions. Socioeconomic factors in perinatal mortality were also shown for both regions, after controlling for gestational age, birth weight, and neonatal intensive care use. In Michigan, infants of mothers with low education had higher mortality rates and in Lorraine residents of low income areas had higher mortality rates. A higher proportion of Michigan women delivered in hospitals with neonatal intensive care than in Lorraine, in all weight/gestation categories. Perinatal mortality rates were also lower in Michigan than in Lorraine, overall and within birth weight categories.
本研究调查了美国和法国地区影响新生儿重症监护使用情况及围产期死亡率的因素，这两个国家拥有相似的医疗保健系统，但在医疗融资方式上有所不同。该研究采用了1984年密歇根州的出生证明和洛林地区的出生登记数据。研究表明，地理可及性和社会经济地位在决定两个地区新生儿重症监护的使用情况方面都很重要。在控制了孕周、出生体重和新生儿重症监护使用情况后，两个地区围产期死亡率的社会经济因素也得到了体现。在密歇根州，母亲受教育程度低的婴儿死亡率较高，而在洛林地区，低收入地区的居民死亡率较高。在所有体重/孕周类别中，密歇根州在设有新生儿重症监护的医院分娩的女性比例高于洛林地区。总体而言以及在出生体重类别中，密歇根州的围产期死亡率也低于洛林地区。
